{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T18:52:32Z","timestamp":1788288752466,"version":"build-2803163510"},"reference-count":67,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,11,10]],"date-time":"2021-11-10T00:00:00Z","timestamp":1636502400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Irritable bowel syndrome (IBS) is a highly prevalent and economically burdensome condition; and pain is often the most unpleasant, disruptive, and difficult\u2010to\u2010treat symptom. Visceral hypersensitivity is a common feature driving pain in IBS, suggesting that neuropathic mechanisms may be implicated. We conducted a systematic review of available evidence to examine the role of anti\u2010neuropathic medicines in the management of pain in IBS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We systematically searched scientific repositories for trials investigating conventional oral, and\/or parenteral, pharmaceutical antineuropathic treatments in patients with IBS. We summarized key participant characteristics, outcomes related to pain (primary outcome), and selected secondary outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key results<\/jats:title>\n                    <jats:p>\n                      We included 13 studies (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0629 participants): six investigated amitriptyline, three duloxetine, three pregabalin, and one gabapentin. There was considerable methodological and statistical heterogeneity, so we performed a narrative synthesis and limited meta\u2010analysis. Amitriptyline was most extensively studied, though only in diarrhea\u2010predominant patients. In individual trials, amitriptyline, pregabalin and gabapentin generally appeared beneficial for pain outcomes. While duloxetine studies tended to report improvements in pain, all were un\u2010controlled trials with high risk of bias. Meta\u2010analysis of three studies (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0278) yielded a pooled relative\u2010risk of 0.50 (95%CI 0.38\u20130.66) for not improving with anti\u2010neuropathic agent vs control. We did not identify any eligible studies investigating the role of parenteral anti\u2010neuropathics.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and inferences<\/jats:title>\n                    <jats:p>Anti\u2010neuropathic analgesics may improve pain in IBS, and deserve further, high\u2010quality investigation, potentially considering parenteral administration and agents with minimal gastrointestinal motility effects. Investigation of amitriptyline\u2019s efficacy in non\u2010diarrhea\u2010predominant subtypes is currently lacking, and we recommend particular caution for its use in IBS\u2010C.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nmo.14289","type":"journal-article","created":{"date-parts":[[2021,11,10]],"date-time":"2021-11-10T07:45:51Z","timestamp":1636530351000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Oral and parenteral anti\u2010neuropathic agents for the management of pain and discomfort in irritable bowel syndrome: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2625-6867","authenticated-orcid":false,"given":"Andrew","family":"Lambarth","sequence":"first","affiliation":[{"name":"University College London Hospitals NHS Foundation Trust Pain Education Research Centre University College Hospitals NHS Foundation Trust: PERC@UCLH London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Zarate\u2010Lopez","sequence":"additional","affiliation":[{"name":"University College London Hospital Gastrointestinal Physiology Unit Pain Education Research Centre University College Hospitals NHS Foundation Trust: PERC@UCLH London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Fayaz","sequence":"additional","affiliation":[{"name":"University College Hospitals NHS Foundation Trust Pain Education Research Centre University College Hospitals NHS Foundation Trust: PERC@UCLH London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,11,10]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2012.02.029"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/flgastro-2014-100542"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2001.05258.x"},{"key":"e_1_2_10_5_1","unstructured":"National Institute for Health and Care Excellence (NICE).Irritable bowel syndrome in adults: diagnosis and management [CG61][Internet]. 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